I have a client who has a fringe benefit plan with over 100 participants that has health insurance paid partially by the employer and pre-tax through a cafeteria plan by the employee. They also have dental paid pre-tax by the employee. The client also has a welfare benefit plan for STD paid after tax by the employee and LTD and Life Insurance premiums paid by the employer. Do I just need to file a 5500 for the welfare benefits and Sch. A? In filing the Sch. A how do you know when to report as experience or non-experience rated? HELP!

Tcunagin

The simple answer is that very few LTD and Group Life plans are experience rated unless there are typically over 1,000 participants. STD, on the other hand can be experienced rated on 100 or more lives. Experience rating on medical plans typically starts at around 200 lives, but insurers vary this based on their underwriting standards.

The group insurers are required to provide the plans with Schedule A information and this information will tell you if the plans are experienced rated. Contact the insurers.